Seli's Article - Health

KESEHATAN HEALTH Waspadai Sinyal Pandemi Be wary / keep on guard againts the Pandemic Signal Layanan Medis Harus Disiapkan Medical Service Must be Prepared JAKARTA, KOMPAS-Penyebaran virus influenza A-H1N1 yang menular antarmanusia terus meluas ke sejumlah negara di dunia. Kondisi ini perlu diwaspadai sebagai sinyal akan terjadi pandemi. Untuk mengantisipasi hal itu, sistem kesiapsiagaan menghadapi pandemi influenza di Indonesia perlu segera dibenahi. JAKARTA, KOMPAS-The spreading of A-H1N1 influenza virus that infect / spread / contaminate inter-human then expanding to some countries in the world. This condition needs to be kept on guard / this condition need be kept on guard as the / a signal will occur pandemic. To anticipate that thing, the readiness systems confront the influenza pandemic in Indonesia need to be improved immediately. Meski belum ditemukan kasus influenza A-H1N1 di Indonesia, Ketua Perhimpunan Dokter Paru Indonesia Prof. Faisal Yunus dalam seminar Swine Flu di Jakarta mengingatkan kemungkinan virus itu masuk ke Indonesia dan penyebarannya telah sampai ke Asia. “Pandemi terjadi bila virus menyebar hampir semua kawasan, tidak mesti angka kematian tinggi”, ujarnya. Although having not been found by the case of A-H1N1 influenza in Indonesia, The Chief of Indonesia Lung Doctor Association Prof. Faisal Yunus in the Swine Flu seminar in Jakarta reminding the probability of that virus enter Indonesia and the spreading had arrived to Asia. ”Pandemic occurs / happens if the virus spreads almost / nearly all / all of areas, it is not sure the high death rate”, he said. Menurut Dr Mukhtar Ikhsan dari Departemen Pulmonologi dan Ilmu Kedokteran Respirasi Fakultas Kedokteran Universitas Indonesia-Rumah Sakit Persahabatan, pandemi influenza A-H1N1 kemungkinan akan terjadi. Ini ditandai adanya sinyal klinis, epidemiologis dan virologis. According to Dr. Mukhtar Ikhsan from the Pulmonology Department and Respiration Medical Science Faculty of the Medical Indonesia University-Persahabatan Hospital, A-H1N1 influenza pandemic would probability occur. This was marked the existence of clinic signal, epidemiology and virology. Pandemi influenza Spanyol tahun 1918-1919 terjadi beberapa gelombang dalam dua tahun dan diperkirakan kematian 40 juta orang. Pandemi influenza Asia 1957-1958 juga dua gelombang. The Pandemic of Spain Influenza in 1918-1919 occured some phases in two years and being estimated the death of 40 million people. Asia influenza pandemic was two phases in 1957-1958.

Menurut Mukhtar, “bila influenza A-H1N1 memasuki fase 6 atau pandemi, jumlah orang yang terinfeksi diperkirakan lebih banyak lagi”. Beberapa faktor yang mempengaruhi adalah tingkat kepadatan penduduk dan pola monobilitas penduduk. According to Mukhtar, “if A-H1N1 influenza enters 6th phase or pandemic, the total of infected people were estimated more and more. Influencing some factors are the level of inhabitant density / population and the pattern of inhabitant monobility. Sinyal klinis pandemi adalah terbukti ada penularan antarmanusia. Sinyal virologis perlu diwaspadai, yaitu perubahan genetik karena virus mengandung material genetik manusia dan hewan maupun mutasi virus. Menurut Mukhtar, “deteksi dini virus baru merupakan ancaman akan ada pandemi dan sinyal epidemiologis penting karena sensitif, bisa dipercaya untuk segera memulai tindakan penanggulangan sebelum konfirmasi virologis”. The signal of the pandemic clinic was proved that there was inter-human’s spreading. The signal of virology needs to be kept on guard, that is the change of genetic because the virus contains the material of human genetic and animal even the virus mutation. According to Mukhtar, “a new virus early detection is threat to be pandemic and the epidemiological signal is important because of being sensitive, can be believed to begin the act of tackling before the confirmation of virology immediately. Tandanya, ada kluster penderita atau kematian karena pneumonia yang tak jelas penyebabnya, kluster pneumonia tanpa hubungan darah, penularan pada petugas kesehatan yang merawat penderita. Proven that there were the cluster sufferer or death because of unclear causal of pneumonia, the pneumonia cluster without blood contact, spreading to the health officer that treats the sufferer. Layanan medis dikatakan tak akan memadai. Sebab jumlah penderita sangat banyak, sedangkan persediaan obat antivirus, vaksin interpandemi dan pandemi terbatas, fasilitas medis, seperti ventilator dan unit perawatan intensif terbatas. Tanpa intervensi, penyebaran internasional terjadi dalam sebulan. Medical service would not be adequate that was said. Because the total of sufferers was very plenty, while / meanwhile the supply of antivirus medicine / cure / drug / remedy, limited inter-pandemic and pandemic vaccines, medical facility, such as ventilator and limited intensive treatment unit. Without intervention, international spreading occured / occurred in a month. Maka perlu dilakukan pelatihan pandemi tingkat RS dan sarana kesehatan, tingkat sistem bersama subsistem lain, persediaan obat antivirus, pengadaan vaksin dan alat penunjang diagnosis. Tim pandemi RS perlu dibentuk untuk memobilisasi sumber daya, menyiapkan sarana medis dan pelatihan petugas. So need be executed the pandemic training of hospital level and health tool, system level with another subsystem, antivirus medicine stock, vaccine supplying and diagnose support tool. The hospital pandemic team needs to be shaped / formed to mobilize the resource, preparing the medical tool and officer’s training. Penanggulangan awal adalah isolasi penderita klinis, identifikasi orang tanpa gejala tetapi kontak erat dengan penderita. ”Pengobatan antivirus oseltamivir diberikan 48 jam pertama”,kata Dr Priyanti Soepandi, ahli paru dari FKUI-RS Persahabatan. Menurut Priyanti,”Cegah penularan dengan cara antara lain tutup hidung dan mulut dengan tisu saat batuk atau bersin, cucilah tangan, hindari kontak dengan orang sakit, tunda perjalanan ke daerah terjangkit virus A-H1N1.

Overcoming of beginning are clinic sufferer isolation, man identification without symptom but strong contact with the sufferer, ”oseltamivir anti-virus therapy is given by first 48 hours”, Dr Priyanti Soepandi of lung specialist from FKUI - Persahabatan hospital said. According to Priyanti, ”prevent the spreading with the methods among of them : close the nose and mouth with tissue when coughing or sneezing, wash the hand, avoid the contact with the sick man, delay the trip to the infected A-H1N1 virus area”. Di Yogyakarta, uji usap lendir dan pengambilan darah pada babi mulai dilakukan. Sementara itu, di Surabaya, Siti Ngaisah tenaga kerja Indonesia dari Taiwan sempat dicurigai terkena influenza A, namun setelah diisolasi dan diobservasi di RSU Dr Soetomo, ia dinyatakan negatif. In Yogyakarta, the test of mucous wiping and taking the pig blood began being executed. Meanwhile, in Surabaya, Siti Ngaisah is Indonesian labor from Taiwan of being suspected that was got A influenza, nevertheless after being isolated and being observed in RSU Dr Soetomo, she was clarified negative. Dinas kesehatan Jombang pun kini menyiapkan obat oseltamivir dari persediaan tahun lalu. Now Jombang health service prepares the oseltamivir medicine from the stock last year.